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January 24, 2013

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Trial to emphasize family doctor system

SHANGHAI plans a trial introduction of Western-style primary medical care at one or two community hospitals in the Changning District, officials from Shanghai Health Bureau said yesterday.

The system, which would start this year, will have general practitioner physicians whose routine visits with patients will be covered by the patients' local medical insurance.

In the trial, GP physicians will sign service agreement with residents, who agree to visit the GPs for medical consultation and primary diagnosis and treatment at least five times a year while insurance pays the GPs' service fees.

Family doctors like GPs treat chronic and common diseases, give advice on health problems and help arrange patient transfers to higher-level hospitals when necessary.

"Shanghai has planned to significantly promote family doctors, who should play a similar role as those in Western countries," said Liu Hongwei, community health chief of the Shanghai Health Bureau.

"The biggest obstacles to promoting GPs are their limited quantity, medical capability and medical insurance payments, which don't currently support patients visiting GPs for primary care."

Liu said the trial will learn from Western experience to provide higher insurance pay to GPs who serve more people and have better medical capabilities.

"If the trial in Changning runs smoothly, we will further spread the format to more areas," Liu said.

"However it should take about five to 10 years to change the current medical service format, as patients can now go to whichever hospitals they want and most patients go to big hospitals, which are crowded with patients with common and chronic diseases."

The Shanghai Health Bureau will work out rules this year on the duties and services of the GPs and how to spread the service. The bureau will also carry out a new rule giving preference to GPs in arranging patient transfers to higher-level hospitals through an online appointment system. Each GP would serve 800 families, or 2,000 to 5,000 residents.


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